CN104936545B - The system and method for design intervention program - Google Patents

Abstract

The method of the program of design arrangement intervention apparatus includes receiving the model of anatomical structure.The anatomical structure includes multiple channels.This method further comprises identifying object construction in a model, and receives the information of the operational capacity about intervention apparatus in multiple channels.This method further comprises based on the identification of intervention apparatus operational capacity for positioning intervention apparatus distal end to execute the design arrangement position of program to object construction.

Description

The system and method for design intervention program

Invention field

This disclosure relates to implement the system and method for minimally invasive procedure across patient anatomy, relate more specifically to design cloth The system and method for setting the program of intervention apparatus.

Background of invention

Minimally invasive medical technology is intended to reduce the tissue mass that damages in intervention program process, to reduce patient recovery times, Do not accommodate harmful side effect.This minimal invasive techniques can be cut by the natural aperture of patient anatomy or by one or more surgeries Mouth carries out.By these natural apertures or notch, clinician can be inserted into intervention apparatus (including surgery, diagnosis, treatment or work Tissue examination instrument) reach targeted tissue site.To reach targeted tissue site, minimally invasive intervention apparatus may pass through anatomy system As lung, colon, intestines, kidney, heart, the circulatory system, or the like in nature or surgery generate channel.To assist clinician So that instrument is passed through channel, the model in channel is prepared using the imaging of preoperative or operation room.Being currently used in arrangement intervention apparatus is Instrument position is accredited as the point in analog channel closest to targeted tissue site by system.In view of intervention apparatus or anatomical structure Limitation, this closest approach position is likely difficult to reach.Improved system and method are needed to determine for target The design instrument position of tissue location implementation procedure.

Summary of the invention

Appended claims summarise embodiments of the present invention.

In one embodiment, the method for the program of design arrangement intervention apparatus includes receiving the mould of anatomical structure Type.The anatomical structure includes multiple channels.Method further comprises identifying object construction in a model, and receives about intervention The information of operational capacity of the instrument in multiple channels.Method further comprises that the operational capacity based on intervention apparatus, identification are used In the distal end of positioning intervention apparatus to execute design arrangement position (the planned deployment of program to object construction location)。

In another embodiment, system includes non-transitory computer-readable medium, and it includes be situated between for design arrangement Enter the computer executable instructions of the program of instrument.Computer executable instructions include the anatomy knot that reception includes multiple channels The instruction of the model of structure and the instruction for identifying object construction in a model.Computer executable instructions further include receiving about Jie Enter the instruction of the information of operational capacity of the instrument in multiple channels and the operational capacity based on intervention apparatus is identified for positioning Intervention apparatus distal end is to execute object construction the instruction of the design arrangement position of program.

Brief description

The aspect of the disclosure reads to be described in detail below in conjunction with the accompanying drawings and will obtain most adequately understanding.Note that according to Industry standard practice, various important documents are not necessarily to scale.In fact, the size of various important documents may appoint to discuss clear Meaning increases or decreases.In addition, the disclosure can in various embodiments repeated reference number and/or letter.Such repetition its Purpose is simple and clear, rather than itself indicates the relationship between the different embodiments and/or configuration.

Fig. 1 is the remote-operated interventional systems according to disclosure embodiment.

Fig. 2 examples use the intervention apparatus system in terms of the disclosure.

Fig. 3 examples have the distal end of the intervention apparatus system of Fig. 2 of elongation intervention tool.

Fig. 4 Example anatomical model images, wherein intervention apparatus distal end are in position.

Fig. 5 is the view of the part of Fig. 4.

Fig. 6 Example anatomical model images, wherein intervention apparatus distal end are in based on the modified cloth set of sensor feedback It sets.

Fig. 7 is the flow chart of the method for the design arrangement position of description identification intervention apparatus.

Fig. 8 is the flow chart for describing the method based on sensor feedback amendment design position.

Fig. 9 is flow chart of the description using the method for imaging system identification object construction.

Figure 10 and 11 is the example of the method for Fig. 9.

Detailed description of the invention

Below in the detailed description in terms of the present invention, it is proposed that many details are to provide to disclosure embodiment party Formula is fully understood.It will be apparent, however, to one skilled in the art that the practice of disclosure embodiment can be not necessarily to these Detail.In other instances, well known method, program, component and circuit are not described in detail, thus will not be unnecessary Ground makes the aspect indigestion of embodiment of the present invention.Moreover, to avoid unnecessary repeated description, according to an exemplary reality The one or more components or action that the mode of applying describes can be used or be omitted when suitable for other illustrative embodiments.

Following description describes different instruments and instrument portions for putting up with its state in three dimensions.As herein Used, the position of the part of term " positioning " referents or object in three dimensions is (for example, along cartesian X, Y, Z coordinate Three translation freedoms).As used herein, rotation arrangement (three rotations of the part of term " orientation " referents or object Turn degree of freedom --- for example, rolling, pitching and deflection).As used herein, the part of term " posture " referents or object At least one translation freedoms positioning and object or object part at least one rotary freedom orientation (up to total Six-freedom degree altogether).As used herein, term " shape " refers to one group of posture, positioning or the orientation measured along object.

Fig. 1 of refer to the attached drawing, the remote operation intervention system for such as surgery, diagnosis, treatment or biopsy procedure System is generally indicated by Ref. No. 100.As shown in Figure 1, remote operating system 100 generally comprises intervention manipulator assemblies 102, distinct program is carried out to patient P for operating intervention apparatus 104.Component 102 is installed on operation console O or is mounted on operation console Near O.Master component 106 allows surgeon S to watch surgical site and control from manipulator assemblies 102.

Master component 106 can be located at surgeon console C, and surgeon console C, which is usually located at operation console O, mutually to have sexual intercourse Between.However, it should be understood that surgeon S can be located at different rooms or entirely different building from patient P.Master component 106 is overall Upper includes optional carrier 108 and one or more control devices 112, and the control device 112 is for controlling manipulator assemblies 102.Control device (one or more) 112 may include that any number of a variety of input units, such as control stick turn ball, data hand Set, triggering rifle, manual operation controller, speech recognition equipment, body action or there are sensor, or the like.In some realities It applies in mode, control device (one or more) 112 is provided with degree of freedom identical with associated intervention apparatus 104, to carry Supply surgeon remotely presents or the perception of control device (one or more) 112 and 104 one of instrument so that surgery is cured There is the strong feeling for directly controlling instrument 104.In other embodiments, control device (one or more) 112 can have Than 104 more or less degree of freedom of related intervention apparatus, and still surgeon is supplied to remotely to present.In some embodiments In, control device (one or more) 112 is manual input device, is moved with six-freedom degree, and may also include actuating Handle, for activating instrument (for example, being closed gripper, application potential to electrode, delivering drug therapy or similar effect).

In alternative embodiments, remote operating system may include more than one from manipulator assemblies and/or more than one A master component.The exact amount of manipulator assemblies will depend on surgical procedure and operate the limitation of indoor space and other because Element.Master component can juxtaposition or its can be positioned on individual position.It is different that multiple master components allow more than one operating personnel to control Combination it is one or more from manipulator assemblies.

Optional visualization system 110 may include endoscopic system so that (real-time) image is provided surgical site simultaneously Give surgeon console C.Simultaneously image can be for example be located in surgical site endoscope probe shooting two dimension or 3-D view.In this embodiment, visualization system 110 include endoscope components, can integration or be removably coupled In intervention apparatus 104.However, in alternative embodiments, it is available to attach to the independent interior of independent manipulator assemblies Sight glass is imaged surgical site.Optionally, independent endoscope assembly can be operated directly by user, no remote operation control. Endoscope assembly may include active steering structure (for example, turning to silk by remote operation) or passive steering structure (for example, passing through Seal wire or user directly navigate).Visualization system 110 can be used as hardware, firmware, software, or combinations thereof implement, with one Or multiple computer processors interact or are executed by one or more computer processors, which may include The processor (one or more) of control system 116.

Display system 111 can show the image for the surgical site and intervention apparatus that visualization system 110 is shot.Display 111 and main control unit (one or more) 112 it is orientable so that the imaging device and intervention apparatus in display assembly phase The relative positioning of surgeon's eye and hand (one or more) is similar to positioning, therefore operating personnel can manipulate intervention apparatus 104 and main control unit (one or more) 112, as watched the working space substantially really presented.True present means The organization chart picture of display is presented to operating personnel, as operating personnel are present in imager positions and from imager angle in person Direct viewing tissue.

Alternatively, or in addition, the surgery position using imaging technique preoperative record and/or simulation can be presented in display system 111 Point image, the imaging technique such as computerized tomography (CT), magnetic resonance imaging (MRI), fluoroscopy, thermography, ultrasonic wave, Optical coherence tomography (OCT), thermal imaging, impedance imaging, laser imaging, nanotube x-ray imaging or similar techniques.It is in Existing pre-operative image may include two dimension, three-dimensional or four-dimensional (including for example, information) based on the time or based on speed image.

In some embodiments, display system 111 can show virtual visualization image, wherein by coming from simulation dissection The physical location of preoperative or framing simultaneously (for example, dynamic reference) intervention apparatus of structure, to be presented to outside surgeon S The virtual image of inside surgical site at section's instrument end position.

In other embodiments, display system 111 can show virtual visualization image, wherein by coming from simulation dissection The existing image (image for including preoperative record) of structure or the simultaneously physical location of framing intervention apparatus, it is outer to be presented to The virtual image of intervention apparatus at section's doctor's S surgical sites.The image of part intervention apparatus may be superimposed on virtual image, with association Surgeon is helped to control intervention apparatus.

In Fig. 1, control system 116 includes at least one processor (not shown), generally comprises multiple processors, is used for It generates from the control between surgical manipulator assemblies 102, master component 106, visualization system 110 and display system 111.Control System 116 further includes program instruction (for example, computer-readable medium of store instruction), more described herein or complete to implement Portion's method.Although control system 116 is shown as single frame in the rough schematic view of Fig. 1, which may include multiple data Processing circuit (for example, from surgical manipulator assemblies 102 and/or on master component 106), wherein at least part handle optional Ground is neighbouring to carry out from surgical manipulator assemblies, partly carried out at master component, etc..Using a variety of centralizations or distributed number According to any one of processing framework.Similarly, program instruction can be implemented with multiple independent programs or subprogram or it can be integrated At other multiple aspects of remote operating system described herein.In one embodiment, control system 116 supports channel radio Agreement is believed, such as bluetooth, IrDA, HomeRF, IEEE 802.11, DECT and Wireless Telemetry.

In some embodiments, control system 116 may include one or more servo controllers, with to control device The corresponding servo motor of one or more of (one or more) 112 provides power and torque feedback from intervention apparatus 104.It watches It takes controller (one or more) and signal also can be transmitted, the movement of instruction manipulator assemblies 102 extends into trouble by body opening The instrument of inside surgical site in person's body.Any routine appropriate or special servo controller can be used.Servo controller Can be integrated independently of manipulator assemblies 102, or with manipulator assemblies 102.In some embodiments, servo controller and Manipulator assemblies are provided as being positioned at the part of the neighbouring manipulator arm cart of patient body.

Each manipulator assemblies 102 support intervention apparatus 104, and may include the connecting rod of one or more non-servo controls Motion structure (for example, one or more connecting rods in place can be manuallyd locate and be locked, being collectively referred to as setting structure) and long-range The executor of operation.Remote-operated manipulator assemblies 102 are driven by multiple actuators (for example, motor).These motors respond The order of control system 116, the remote-operated executor of active drive.Motor is further coupled to intervention apparatus, to drive Intervention apparatus is entered the anatomy aperture that nature or surgery are formed and is moved the distal end of intervention apparatus, the freedom with multiple degree of freedom Degree may include three linear movement degree (for example, along linear movement of X, Y, Z cartesian axes) and three rotary motion degree (for example, It is rotated around X, Y, Z cartesian axes).Additionally, motor can be used for activating the hinged end effector of instrument in biopsy Look into grasp tissue in clamp of device or the like.

Fig. 2 examples use the minimally invasive system 200 in terms of the disclosure.System 200 can be incorporated into that remote-operated interventional systems, Such as system 100.Optionally, system 200 can be used for detecting program or be related to the intervention apparatus such as laparoscope device of traditional manual operation The program of tool.System 200 include conduit system 202 (for example, part of instrument 104), by interface unit 204 be coupled to Track system 206.Transit system 210 (for example, part of control system 116) processing from virtual visualization system 208, one or The information of multiple imaging systems 212, and/or tracking system 206, in display system 214 (for example, the portion of display system 111 Point) on generate one or more images and show.System 200 can further comprise optional operation and support system (not shown), Such as lighting system, steering control system, irrigation system and/or suction system.

Conduit system 202 includes elongated flexible body 216, with proximal end 217 and distal end 218.Pipeline 219 is in flexible body Extend in 216.In one embodiment, flexible body 216 has about 3mm outer diameters.Other flexible body outer diameters can be larger or smaller. Conduit system 202 optionally includes sensing system comprising alignment sensor system 220 is (for example, electromagnetism (EM) sensor system System) and/or shape sensor system 222 --- for determining at distal end 218 catheter tip and/or along main body 216 1 or more Positioning, orientation, speed, posture, and/or the shape of a segment 224.The distally overall length of the main body 216 between 218 and proximal end 217 Segment 224 can be effectively split into.Alignment sensor system 220 and shape sensor system 222 are docked with tracking system 206.Tracking System 206 can be used as and one or more computer processors interactions or be executed by one or more computer processors Hardware, firmware, software or combinations thereof are implemented, which may include the processor of control system 116.

Alignment sensor system 220 can be EM sensing systems comprising one or more conductive coils, the call wire Circle can be given the electromagnetic field of external generation.Therefore, each coil of EM sensing systems 220 generates electrical signal of reaction, feature The positioning relative to the electromagnetic field of outside generation and orientation depending on coil.In one embodiment, EM sensing systems can It is configured and positions to measure six-freedom degree, for example, three elements of a fix X, Y, Z and three orientation angles --- indicate basic point Pitching, deflection and rolling.Further describing for EM sensing systems is provided in the United States Patent (USP) submitted on the 11st of August in 1999 Numbers 6,380,732, it discloses " Six-Degree of Freedom Tracking System Having a Passive Transponder on the Object Being Tracked ", entire contents are incorporated by reference herein.

Shape sensor system 222 includes the optical fiber that is aligned with flexible body 216 (for example, in internal pipeline (not shown) It provides or outside is installed).Tracking system 206 can be coupled to proximal fiber.In one embodiment, fibre diameter is about 200 μ m.In other embodiments, which can be greater or lesser.

The optical fiber of shape sensor system 222 constitutes fiber kinks sensor, the shape for determining conduit system 202. In a kind of optional mode, provided using the optical fiber including fiber bragg grating (Fiber Bragg Gratings, FBGs) Strain measurement in the structure of one or more dimensions.The system of a variety of monitoring optical fiber shapes and the relative positioning in three dimensions It is described in the U.S. Patent Application No. 11/180,389 submitted on July 13rd, 2005 with method, it discloses " Fiber optic position and shape sensing device and method relating thereto"；2004 7 The U.S. Provisional Patent Application No. 60/588,336 that the moon is submitted on the 16th, it discloses " Fiber-optic shape and relative position sensing"；The U.S. Patent number 6 submitted on June 17th, 1998,389,187, opened " Optical Fibre Bend Sensor ", entire contents are incorporated by reference herein.In other optional modes, utilize Other strain induction technology such as Rayleigh scattering, Raman scattering, Brillouin scattering and sensors of fluorescent scattering can be appropriate 's.In other optional embodiments, the shape of conduit is determined using other technologies.For example, if distal end of catheter posture The time interval of historical storage is less than the time that display or alternating movement (for example, sucking and exhalation) are walked in update, then available Device shape of the posture history reformulation Jing Guo the time interval.As another example, alternating movement cycle can be stored along such as to exhale History posture, positioning or the directional data of the instrument known point of suction.This storage data can be used for establishing the shape about conduit Information.Optionally, it can be used for shape induction such as EM sensors along a series of alignment sensors of conduit positioning.Optionally, journey The data history of alignment sensor such as EM sensors during sequence on instrument can be used for indicating the shape of instrument, especially exist In the case that anatomic passageway is generally static.Optionally, it positions or orients and can be used for by the wireless device that external magnetic field controls Shape incudes.Its position history can be used for determining the shape across channel.

In this embodiment, optical fiber can include multiple cores in single covering.Each core can be single mode, and having makes core The sufficient distance and covering of separation so that significantly interaction occurs for the light that the light of each core is not carried with other cores.In other realities It applies in mode, nuclear volume is changeable, or each core can be comprised in independent optical fiber.

In some embodiments, FBG arrays are provided in each core.Each FBG includes a system of core refractive index Row modulation, to generate the space periodicity of refractive index.Spacing may be selected so that be originated from the part reflection pair of each index variation In narrowband wavelength coherent superposition, therefore by only reflecting this narrowband wavelength when wider band.During manufacturing FBG, Modulation intervals known distance, so as to cause the reflection of known wavelength band.However, when causing strain on fiber core, between modulation Away from will be changed according to core dependent variable.Optionally, with fiber kinks and the backscattering changed or other optical phenomenas can be used for Determine the strain in each core.

Therefore, it is measuring strain, sends light along fiber, and measure the feature of return light.For example, the reflection that FBG is generated Wavelength is the function of fiber strain and its temperature.This FBG technologies are purchased from multiple sources, such as Smart Fibres Ltd.of Bracknell, Britain.Application of the FBG technologies in the alignment sensor performed the operation for remote operation is described in July, 2006 The U.S. Patent number 7 submitted for 20th, 930,065, it discloses " Robotic Surgery System Including Position Sensors Using Fiber Bragg Gratings ", entire contents are incorporated by reference herein.

When applied to multinucleate fibre, the bending of optical fiber causes the strain on core, the strain that can pass through the wave of each core of monitoring It is long to change to measure.By two or more cores with off-axis arrangement in fiber, fiber bending causes difference on each core Strain.These strains are the functions of local fiber bending degree.For example, the core region comprising FBG, if positioned at fiber bending Point, then can be for the bending amount of those determining points.These data are combined with the known spacing in the regions FBG, can be used for reconstructing The shape of fiber.This system by Luna Innovations.Inc.of Blacksburg, Va to be described.

As described above, optical fiber can be used for monitoring the shape of at least partly conduit system 202.More specifically, passing through tracking system 206 The light of optical fiber is passed through in processing, to detect the shape of conduit system 202 and utilize the information assists surgical procedure.Tracking system 206 It may include detecting system, be used to generate and detect the light of the shape for determining conduit system 202.This information can be used in turn Other correlated variables are determined, such as the speed and acceleration of the part of intervention apparatus.Induction can be only limitted to be remotely operated system cause Dynamic degree of freedom, or passive (for example, the deactivated type of stiffener is bent between connector) and active are can be applied to (for example, device The actuating movement of tool) degree of freedom.

Flexible body 216 optionally accommodates one or more image taking probes 226, sends the image data of shooting extremely Imaging system (one or more) 212.For example, image taking probe 226 can be endoscope probe, including have three-dimensional or single As the end section of video camera, solid or single as camera arrangements are near the distal end of flexible body 216 218, for shooting hair It send to the image of imaging system 212 (including video image).Image taking probe 226 may include being coupled to video camera, for sending out Send the cable of the image data of shooting.Optionally, image taking instrument can be the fiber optic bundle for being coupled to imaging system, such as fiber Mirror.Image taking instrument can be single spectrum or multispectral, for example, obtain visible spectrum image data or obtain it is visible and Infrared or ultraviolet spectra image data.

Additionally or alternatively, image taking probe 226 can be sensor probe, with catoptric imaging technology such as ultrasonic wave Or optical coherence tomography (OCT) is applied together.For example, the probe may include that transmitters and receivers are arranged, as ultrasound is changed It can device.Ultrasonic transducer may be mounted to that one end of elongated shaft.Such source, which can be used for obtaining, will carry out intervention program Two dimension or 3-D view or model in the preoperative or art of anatomical area.As two-dimentional source, ultrasonic transducer can be used for obtaining Single ultrasonography.As three-dimensional source, it can be used for obtaining multiple space ultrasonoscopys or editing (cuts), to provide It is enough to build the information of threedimensional model.Therefore, it can be arranged at movement in anatomical site (including rotation), it is this to shoot Image or editing.This generally can for example be realized according to following：The pre-programmed of mobile ultrasonic transducer is controlled by remote operation Sequentially, ultrasonic transducer or similar fashion are moved manually.

Main body 216 can also accommodate cable, connecting rod or extend between interface 204 and distal tip 218 with for example such as distal end Other steering structures control (not shown) of distal end 218 is controllably bent or rotated shown in dotted line version.Conduit system can be It can turn to, or it is alternatively possible to be indeflectible, without the integration mechanism for the bending of operating personnel's control device. Flexible body 216 can further accommodate control mechanism (not shown), be used for for operating surgical end-effector or another manipulate The proximal operating portion of medical functions (such as carrying out the predetermined treatment of destination organization).For example, some end effectors have list A operation element, such as scalpel, blade, optical fiber or electrode.Other end effectors may include pairs of or multiple operation elements, Such as such as pliers, grabber, scissors or applicator.Electrical activation end effector example include electrosurgical electrode, energy converter, Sensor, and the like.

If Fig. 3 is shown in more detail, for such as program of operation, biopsy, ablation, illumination, lavation or suction Intervention tool (one or more) 228 can be arranged by pipeline 219, and the target location application within anatomical structure. Intervertebral tool 228 can also be image taking probe.The tool 228 can be pushed from the opening of pipeline 219, to execute program, Then pipeline is recalled when program is completed.Intervention tool 228 can be from the proximal end of conduit coiled body 217 or another optional along flexible body Instrument port (not shown) remove.

Virtual visualization system 208 walks assistance to the offer of conduit system 202.Virtual using virtual visualization system is worn Row is based on to the acquired and anatomic passageway relevant data group of three-dimensional structure reference.More specifically, virtual visualization System 208 processing using imaging technique such as computerized tomography (CT), magnetic resonance imaging (MRI), fluoroscopy, thermography, Ultrasonic wave, optical coherence tomography (OCT), thermal imaging, impedance imaging, laser imaging, nanotube x-ray imaging or similar The image of technical notes and/or the surgical site of simulation.The image of record is converted into part or all of dissector using software The two dimension or threedimensional model of official or anatomic region.Model describes the different location and shape and its connectivity in channel.For generating The image of model can be recorded in clinical procedure in preoperative or art.In alternative embodiments, virtual visualization system can Utilize the mixing of master pattern (that is, non-patient-specific) or master pattern and patient-specific data.Model and pass through model Generate any virtual image can represent deformable anatomic region during one or more action phases (for example, pulmonary aspiration/ Exhale cycle during) stationary posture.

During virtually walking program, sensing system can be used for big position approximate of the calaculating apparatus relative to patient anatomy It sets.The position can be used for generating the virtual interior view of macroscopic scale the tracking image and patient anatomy of patient anatomy Picture.It is known it is a variety of using fibre optical sensor position and show intervention implement and preoperative record surgery image (Tathagata self-virtualizing can Depending on those of change system) system.Such as the U.S. Patent Application No. 13/107,562 that on May 13rd, 2011 submits --- it is public It opens, " Medical System Providing Dynamic Registration of a Model of an Anatomical Structure for Image-Guided Surgery ", entire contents are introduced into herein as ginseng Examine --- disclose a kind of such system.

Transit system 210, as a part for control system 116, processing from virtual visualization system 208, one or The information of multiple imaging systems 212, and/or tracking system 206, to determine that intervention apparatus reaches target solution by anatomy system Cut open the threaded pass for learning structure.Transit system 210 can also be supervised when intervention apparatus is moved by anatomy system to object construction Survey the threaded pass of intervention apparatus.Transit system 210 includes design module 211, and clinician is made to pass through virtual visualization Positioning targeted anatomy (for example, tumour) and identification are arrived by anatomic passageway in anatomical model prepared by system 208 Up to object construction to carry out the threaded pass of intervention program (for example, biopsy) with intervention apparatus.Target is positioned and is worn The determination of walking along the street diameter can automate so that transit system identifies one or more threaded pass.Optionally, clinician can pass through Anatomical model determines threaded pass, and optionally by selected path communication to transit system.In another optional mode, It designs module to determine using mixing automation/clinician's selection type threaded pass, wherein clinician can change system design Path or in which clinician can input parameter such as the anatomical area to be avoided or to the design proposed by design module 212 The instrument limitation that threaded pass is limited.

It walks design module to generate or clinician is allowed to select the design arrangement position in anatomic passageway, to park The distal end of intervention apparatus, to implement to intervene program.Referring now to Fig. 4, such as tumour of display target structure 302 and neighbouring anatomy The virtual image 300 in channel 304.The channel includes conduit wall 306 and knuckle 308.In this embodiment, anatomic passageway is Pulmonary branches tracheae, but the system and method for the disclosure are applicable in anatomy system such as colon, intestines, kidney, heart or the circulatory system The channel that other natures or surgery generate.Display is with flexible body 309 (being substantially similar to flexible body 216) and elongation intervention work The intervention apparatus of tool 310.In one embodiment, it walks design module design arrangement position is accredited as along anatomic passageway Wall, closest or approaching target structure position 312.However, the degree of approach based entirely on object construction comes choice arrangement position Intervention apparatus can be caused not reachable or be not easily accessible to selected position.For example, intervention apparatus may not be able to be logical It is fully bent in road, to reach the position based on the degree of approach.In addition, selection position or lead to wearing for position Walking along the street diameter does not account for the limitation of the anatomical structure to be avoided, such as scar or illing tissue.

In other embodiments, it walks design module and is based on many factors choice arrangement position, in some cases should Factor can be performance of program, such as determine to the distance of object construction and/or object construction relative to other anatomical features Position.In other embodiments, additionally or alternatively, design module is walked to can receive and operate energy using about intervention apparatus The information of power determines position.Such as, it is contemplated that the information that ability is bent about instrument, such as the flexibility and bullet of conduit material Property, by the steering (example of the conduit or any preformed shape feature of tool of duct conduits, conduit or distal tool end Such as, distal end of catheter is relative to the flexible degree of catheter shaft) and along catheter length curvature.Other features of intervention apparatus Can be also used for determining position, including conduit diameter, tool diameter, when being stretched out from conduit tool path (for example, be bent, Straight), the maximum angulation of movement of tool (for example, sweep away, rotate, linearly), tool shaft and catheter shaft, tool can be stretched out from conduit Maximum length and distal end of catheter provide and any anchoring structure of conduit wall CONTACT WITH FRICTION.About bending ability information and/ Or the information about intervention apparatus feature is can be used for determining operational capacity of the intervention apparatus in anatomic passageway exemplary Factor.

Design module is walked can also or optionally to can receive and determine arrangement using the information about patient anatomy Position.This information may include, for example, most with the position of the immediate anatomic passageway knuckle of object construction and with object construction Close channel size.Other anatomic informations may include the elasticity of anatomic passageway, including any lysis may be to logical The influence that road bullet generates.It walks and designs a model it is also possible to consider surrounding anatomical tissue, for example to select to reduce to surrounding tissue The position of risk.As an example, the position far from lung periphery may be selected, being arranged tool to avoid lung punctures Risk.It walks and designs a model that it is also possible to consider the anatomy for the object construction for leading to object construction optimum position.For example, may be selected Position so that biopsy tool avoids the calcification part of tumour.

Walking design module, it is also possible to consider the relevant informations of the relationship between intervention apparatus and patient anatomy, such as target Structure is at a distance from catheter tip.With reference to figure 5, walking design module, it is also possible to consider the angle of nips between intervention tool and conduit wall 320.For example, 90 ° of angle of nip is small and may be that can not put into practice due to channel size and distal end of catheter bending.1 ° engaging-in Angle can be nuzzled up rather than the risk of penetration channel wall surface is also likely to be unsuitable due to intervention tool.Based on these reasons, wear Position may be selected in row design module so that angle of nip is between about 30 ° and 90 °.

Referring again to Fig. 4, after walking design module evaluation intervention apparatus and patient anatomy's correlative factor, identification dissection Learn the position 314 on conduit wall.Optionally, the suggestion threaded pass for leading to position can be provided by walking design module. Then clinician can be by intervention apparatus distal end guiding to position.Clinician can be based on virtual or real image and instruct hand Dynamic control intervention apparatus is walked.Optionally, clinician can control to remote operation walking for intervention apparatus, or allow to intervene Instrument is computer controlled along the threaded pass suggested and walks.After the distal end of intervention apparatus is located in position, work is intervened Tool is stretched out from conduit, passes through conduit wall and contact target structure.In some cases, for example, being located at anatomy in object construction When in channel, position can be positioned in channel lumens rather than on conduit wall.Such as when object construction is in channel, cloth Seated position can be on the surface of object construction.

Fig. 7 is the flow chart for the method 400 that description is walked used in the design arrangement position of design module identification intervention apparatus. 402, the model of anatomical structure is received.The anatomical structure includes multiple anatomic passageways by the model example.Mould Type utilizes imaging technique such as CT, MRI, fluoroscopy, thermography, ultrasonic wave, OCT, thermal imaging, impedance by preoperative or while in operation Imaging, laser imaging, nanotube x-ray imaging or similar techniques record and/or the two dimension or graphics of the surgical site of simulation As being formed.The reception of model may include receiving by model, user's input of description patient anatomy or other reference sources The information about patient anatomy obtained.This information about patient anatomy may include, for example, anatomic passageway In (one or more) and the immediate position of object construction (one or more) and the immediate anatomic passageway of object construction The position of knuckle and size with the immediate channel of object construction.Other anatomic informations may include the bullet of anatomic passageway Property, lead to object construction optimum position object construction anatomical structure and surrounding tissue type and it is any with contact surrounding group Knit relevant risk.

404, the position of object construction (for example, tumour) is identified in a model.Identification object construction may include from model, The information of the user's input or the determination of other reference sources or reception of object construction about object construction is described.It is this about The information of object construction may include, for example, the one or more substances and target of the shape of object construction, formation object construction Position of the body structure surface relative to neighbouring anatomic passageway.

406, the information about intervention apparatus operational capacity is received.It receives to determine the information of intervention apparatus operational capacity It may include, for example, bending the ability such as information of conduit material flexibility and resilience about instrument, by the conduit or work of duct conduits The steering of any preformed shape feature, conduit or distal tool end of tool and the curvature along catheter length.Intervention apparatus Operational capacity can also be determined by the feature of intervention apparatus, such as the most great achievement of conduit diameter, tool diameter, tool shaft and catheter shaft The maximum length and distal end of catheter that angle, tool can be stretched out from conduit provide any anchoring structure with conduit wall CONTACT WITH FRICTION.

408, the design arrangement position of intervention apparatus is positioned.Design arrangement position can be marked on the model in multiple channels On.Design arrangement position can be based on instrumentation ability information, object construction information, patient anatomy's information or various information Combination select.The position of selection may be in anatomic passageway with the immediate point of object construction.However, very In more patients, the position in closest approach may can not possibly be reached by intervention apparatus distal end, because the instrument is selected There is insufficient bending ability in the size of anatomic passageway and elasticity limitation.It is logical that position more appropriate can be at anatomy Intervention apparatus bends the point in limit of power relative to the angle of nip of conduit wall in instrument on road wall.For example, if intervention apparatus With hardly allow or do not allow bending stiff distal end, then position appropriate can be at grand near object construction It is prominent.At knuckle, intervention apparatus can be arranged in the case of the minimum bending in instrument distal end with the angle of nip with about 90 ° of conduit wall. As another example, it walks design module and position may be selected so that angle of nip is between about 30 ° and 90 °.In choice arrangement When position, design system further acknowledges that intervention tool can extend enough distances from conduit and be intervened to reach object construction Program.

It as described above, can be based on instrumentation ability, object construction and the analysis of patient anatomy come Position Design cloth set It sets.Instead of or combine system evaluation, design arrangement position can be identified by clinician, and be communicated to and walked design module, with The design arrangement position of clinician's identification is positioned or marked in model.Setting for clinician's identification is received when walking design module When counting position, then module can be by it compared with the position of system identification.If the position of clinician's identification By opposition (for example, " the biopsy needle length of selection not enough reaches target from this position."), vision can be sent out or listened Feel feedback prompts.

Optionally, the design multiple optional positions of module identification are walked.Optional position can be encoded (for example, Encoded with color in display), to provide about for arranging intervention apparatus to execute the opposite of the optional position of program The information of performance.A conduct design arrangement position in optional position may be selected in clinician.It optionally, can be from optional Position selects more than one design arrangement position, so that intervention program is carried out from different approaches.If clinician determines The position initially selected is not appropriate for, and the selection of optional position can also carry out during intervening program.

For the step of further refining identification object construction, can be received using one or more of imaging system 212 Collect intervention apparatus be arranged in identification position or its it is general nearby after about object construction position additional information. Referring now to Fig. 6, the virtual image 300 of display target structure 302 and neighbouring anatomic passageway 304 again.The distal end of flexible body 309 It is first positioned in goal verification position, such as position 312.Image taking probe 226 be operable to determine object construction 302 whether phase It is in expected for goal verification position to position.If object construction 302 is not found or is not on expected positioning, can Make flexible body and image taking pop one's head in move left and right, until navigating to object construction.When navigating to object construction, by flexible body 309 or image taking probe remote location be recorded at new position 322.Then the design more new target structure of module 211 is walked The position of 302'.It is identified with the new position of object construction, it is set using the operational capacity information authentication of intervention apparatus is modified Count position 324.For example, position 314 can be updated to using the difference between position 312 and 322 by walking design module The location updating of position 322 and object construction 302 is to 302'.In one embodiment, image taking probe using one or The sensors of multiple catoptric imaging technology such as ultrasonic waves or OCT refines the position of object construction.Optionally, other non-imaged Sensor can be used for identifying the position of object construction.

Fig. 8 is the flow chart for the method 450 that design arrangement position of the design module for correcting intervention apparatus is walked in description. 452, in probe in initial design arrangement position or after goal verification position operates, pops one's head in from image taking and receive letter Breath.454, the correction position of the information authentication object construction received from image taking probe is utilized.456, in multiple channels Model in identify revised design arrangement position.

It is optional to identify that the method 500 of object construction is described in Fig. 9 using imaging system 212, and show in Figure 10 and 11 Example.Method 500 can be carried out to identify initial intervention position, or can be used for identifying modified position, as described below.

502, conduit is made to be walked under the guidance of transit system to channel position such as position 312 or 314, the transit system Guidance include such as vision, EM or shape sensor information.Can provide when conduit arrived position from clinician or The confirmation of intervention apparatus.504, imaging probe (for example, ultrasonic probe) is inserted through conduit, and track imaging probe phase Movement for part conduit (for example, catheter tip).In some embodiments, it can also be used during 502 walk Identical imaging probe (for example, identical ultrasonic probe).The movement of traceable imaging probe, such as utilize alignment sensor such as 5 or 6 Degree of freedom EM sensors.Optionally, the fortune is tracked using the plug in sensor such as encoder outside patient anatomy It is dynamic.Optionally, the movement can be tracked to control the insert action of imaging probe by connecting stepper motor.

506, the roll angle of the imager coordinate system of imaging probe is determined relative to conduit.For example, using axial direction at Roll angle is determined as the rolling alignment important document of probe and conduit (for example, critical system).Optionally, it can be used and be located at patient's solution Cut open the roll sensor outside structure.In another optional mode, can have by being observed in the image that imaging probe records The one or more labels or other important documents of the angle relative to conduit known determine roll angle.For example, important document or label can Positioned at conduit periphery, and with the contrast (for example, ultrasound contrast) with conduit.

508, conduit and/or imaging probe is made to be moved around anatomic passageway, to be examined in the image that probe generates Survey object construction.510, after detecting object construction by imaging probe, clinician is using in indicator post Instruction device identify object construction in the picture.It can be by breathing and/or the scanning of cardiac cycle gating, to generate image (for example, ultrasonoscopy).Can 3-D view be built by two-dimensional scan.

512, indicator post is transformed into catheter coordinates system or patient coordinate's system (has been positioned to conduit before this Coordinate system).514, apply relative to the object construction identified in anatomical model in the preoperative using indicator post The offset of position.Based on the modified object construction position of the calculations of offset.Then imaging probe can be removed, and can be by biopsy Look into tool or other intervention tools be inserted by conduit, at correction position into line program (for example, biopsy).

Although having described the pulmonary branches tracheae of the system and method for the disclosure for connection, its be also applied for by natural or A variety of anatomy systems are walked and handled to the communicating passage that surgery generates --- including colon, intestines, kidney, brain, heart, cyclic system System or similar system --- any one of in its hetero-organization.Disclosed method and embodiment are also suitable for non-intervention type Using.

One or more of embodiments of the present invention element can implemented in software be such as to be controlled in computer system It is executed in the processor of system 116.When embodied in software, the element of embodiment of the present invention is substantially to execute required task Code segment.Program or code segment can be used as the computer data embodied in carrier wave letter by transmitting medium or communication connection It number has been downloaded, and has been storable in processor readable storage medium or device.Processor readable storage devices may include appointing What can store the medium of information, including optical medium, semiconductor medium and magnetic medium.Processor readable storage devices example includes Circuit；Semiconductor device, semiconductor storage, read-only memory (ROM), flash memory, Erasable Programmable Read Only Memory EPROM (EPROM), floppy disk, CD-ROM, CD, hard disk or other storage devices, code segment can be by computer networks such as The downloads such as Internet, Intranet.

Note that the process and display of displaying can not be inherently related to any specific computer or other equipment.It is a variety of this Structure needed for a little systems will be used as element to present in the claims.In addition, embodiments of the present invention do not refer to any tool Body programming language describes.It can understand that introduction for carrying out the present invention can be such as described herein in a variety of programming languages.

Although being described in the accompanying drawings and showing certain illustrative embodiments of the present invention, it is to be understood that these are implemented Mode be it is exemplary and and unrestricted wide in range invention, and embodiments of the present invention be not limited to be shown and described it is specific Construction and arrangement, because those skilled in the art are contemplated that various other modifications.

Claims (38)

1. a kind of method of the program of design arrangement intervention apparatus, the method are carried out by processing system, the method includes：

The model of anatomical structure is received, the anatomical structure includes multiple channels；

Object construction is identified in the model；

Receive the information of the operational capacity about the intervention apparatus in the multiple channel；

Based on the information of the operational capacity about the intervention apparatus received, identification position the distal end of the intervention apparatus with The object construction is executed in each of multiple optional positions and the multiple optional position of described program Relative performance；And

The multiple optional position in the model is shown on the display system, wherein by using providing about described Each of multiple optional positions are for arranging the intervention apparatus to execute the information of the relative performance of described program It encodes to show each of the multiple optional position.

2. according to the method described in claim 1, wherein identifying that the multiple optional position includes receiving to represent to be given an account of Enter the data of the one or more features of instrument, one or more of features include tool arrangement length.

3. according to the method described in claim 1, wherein identifying that the multiple optional position includes receiving to represent to be given an account of Enter the data of the one or more features of instrument, one or more of features include the bending ability of the intervention apparatus.

4. according to the method described in claim 1, wherein identifying that the multiple optional position includes receiving to represent to be given an account of Enter the data of the one or more features of instrument, and the wherein described intervention apparatus includes catheter main body and intervention tool, it is described One or more features include motion feature of the intervention tool relative to the catheter main body.

5. according to the method described in claim 1, it is described more wherein to identify that the multiple optional position is represented including reception The data of the feature in a channel.

6. according to the method described in claim 5, the feature in wherein the multiple channel includes closest with the object construction Multiple channels size.

7. according to the method described in claim 5, the feature in wherein the multiple channel includes two in the multiple channel Between knuckle position.

8. according to the method described in claim 5, the feature in wherein the multiple channel includes the elasticity in the multiple channel.

9. according to the method described in claim 1, wherein identifying that the multiple optional position includes receiving to represent the mesh Mark the data of the feature of structure.

10. according to the method described in claim 9, the feature of the wherein described object construction includes calcification position.

11. according to the method described in claim 1, further comprising by being identified in institute from the multiple optional position State the preliminary position in one in multiple channels, and the sensor number based on the correction position for indicating the object construction According to reception the preliminary position is modified to the design arrangement position, and reflect from the multiple optional position Determine design arrangement position.

12. according to the method for claim 11, wherein the sensor data packet include represent the object construction relative to The Ultrasonic Sensor Data of the position of the distal end of the intervention apparatus.

13. according to the method for claim 11, wherein the sensor data packet include represent the object construction relative to The OCT sensor data of the position of the distal end of the intervention apparatus.

14. according to the method described in claim 1, being wherein used for the corresponding optional arrangement in the multiple optional position The coding of position is the color for the relative performance for indicating the corresponding optional position.

15. according to the method described in claim 1, wherein described program is biopsy procedure.

16. according to the method described in claim 1, further comprising selecting from the multiple optional position by receiving Clinician identification position, the appraisal and design position from the multiple optional position.

17. according to the method for claim 16, further comprising providing alarm, the arrangement of clinician's identification is indicated Opposed position.

18. according to the method for claim 16, wherein the intervention apparatus is distally and logical at the design arrangement position Angle of nip between road wall is between 30 and 90 degree.

19. a kind of system of the program of design arrangement intervention apparatus, the system comprises：

Non-transitory computer-readable medium includes the computer executable instructions of the program for design arrangement intervention apparatus, The computer executable instructions include

The instruction of the model of anatomical structure is received, the anatomical structure includes multiple channels；

The instruction of object construction is identified in the model；

Receive the instruction of the information of the operational capacity about the intervention apparatus in the multiple channel；With

Information authentication based on the operational capacity about the intervention apparatus received position the distal end of the intervention apparatus with It is opposite in each of multiple optional positions and the multiple optional position to object construction execution described program The instruction of performance；With

The instruction of the multiple optional position in the model is shown on the display system, wherein by using pass is provided In each of the multiple optional position for arranging the intervention apparatus to execute the relative performance of described program Information encodes to show each of the multiple optional position.

20. system according to claim 19 further comprises the intervention apparatus.

21. system according to claim 19, wherein identifying that the multiple optional position includes receiving described in representative The data of the one or more features of intervention apparatus, one or more of features include tool arrangement length.

22. system according to claim 19, wherein identifying that the multiple optional position includes receiving described in representative The data of the one or more features of intervention apparatus, one or more of features include the bending ability of the intervention apparatus.

23. system according to claim 19, wherein identifying that the multiple optional position includes receiving described in representative The data of the one or more features of intervention apparatus, and the wherein described intervention apparatus includes catheter main body and intervention tool, institute It includes motion feature of the intervention tool relative to the catheter main body to state one or more features.

24. system according to claim 19, wherein identifying that the multiple optional position includes receiving described in representative The data of the feature in multiple channels.

25. system according to claim 24, wherein the feature in the multiple channel includes most being connect with the object construction The size in close multiple channels.

26. system according to claim 24, wherein the feature in the multiple channel includes two in the multiple channel The position of knuckle between a.

27. system according to claim 24, wherein the feature in the multiple channel includes the elasticity in the multiple channel.

28. system according to claim 19, wherein identifying that the multiple optional position includes receiving described in representative The data of the feature of object construction.

29. system according to claim 19, wherein the feature of the object construction includes calcification position.

30. system according to claim 19 further comprises by being identified from the multiple optional position The preliminary position in one in the multiple channel, and the sensor based on the correction position for indicating the object construction The preliminary position is modified to the design arrangement position by the reception of data, and from the multiple optional position Appraisal and design position.

31. system according to claim 30, wherein the sensor data packet include represent the object construction relative to The Ultrasonic Sensor Data of the position of the distal end of the intervention apparatus.

32. system according to claim 30, wherein the sensor data packet include represent the object construction relative to The OCT sensor data of the position of the distal end of the intervention apparatus.

33. system according to claim 30, wherein for the corresponding optional cloth in the multiple optional position The coding of seated position is the color for the relative performance for indicating the corresponding optional position.

34. system according to claim 19, wherein described program are biopsy procedures.

35. system according to claim 19 further comprises selecting from the multiple optional position by receiving The position for the clinician's identification selected, the appraisal and design position from the multiple optional position.

36. system according to claim 35 further comprises that the instruction for providing alarm, the alarm indicate the clinic The position of doctor's identification is opposed.

37. system according to claim 35, wherein at the design arrangement position distal end of the intervention apparatus and Angle of nip between conduit wall is between 30 and 90 degree.

38. a kind of design passes through processing system using the method for the intervention program for the intervention tool arranged from conduit, the method It carries out, the method includes：

The model of anatomical structure is received, the anatomical structure includes multiple channels；

Object construction is identified in the model；

Receive the information about the intervention tool relative to the development length of the distal end of the conduit；

Based on the information of the development length about the intervention tool received, identification for position the distal end of the conduit with The object construction is executed every in the multiple optional positions and the multiple optional position of the intervention program A relative performance；With

The multiple optional position in the model is shown on the display system, wherein by using providing about described Each of multiple optional positions are for arranging the intervention apparatus to execute the information of the relative performance of described program It encodes to show each of the multiple optional position.